ACL reconstruction

The anterior cruciate ligament (ACL) is a central stabilising structure of the knee. ACL rupture is one of the most common serious sporting injuries, typically occurring during pivoting, cutting or landing movements in sports such as football, netball, basketball and skiing. It usually presents with an audible pop, immediate swelling, and a feeling of the knee giving way.

Diagnosis

Clinical diagnosis is made on examination with Lachman's and pivot shift tests. MRI confirms ACL rupture and identifies associated injuries to the menisci, cartilage and other ligaments, which are common at the time of ACL injury.

Non-surgical management

For some patients, particularly older, less active individuals or those with low functional demands, physiotherapy-based rehabilitation without surgery can achieve good outcomes. The decision is made together with Dr Myhill based on your activity goals, instability symptoms and associated injuries.

ACL reconstruction surgery

ACL reconstruction involves replacing the torn ligament with a tendon graft. This is performed arthroscopically through small portals, with the graft passed through precisely positioned bone tunnels in the femur and tibia and secured with fixation devices. The procedure typically takes 60–90 minutes.

Recovery and return to sport

Rehabilitation after ACL reconstruction is a graded process taking 9–12 months for return to unrestricted sport. Criteria-based rehabilitation, rather than time alone, guides progression through each phase. Full participation in contact and pivoting sports is not recommended until objective strength and functional testing criteria are met.